Cedars-Sinai Medical Director, Quality in Beverly Hills, California
The Medical Director for Quality and Clinical Performance works closely with the Chief Medical Officer and the Director, Quality and Performance Improvement, to promote the highest quality of care and to enhance the culture of safety in the Cedars-Sinai Medical Network. Working in a dyad relationship with the Director, Quality and Performance Improvement, the incumbent oversees processes to ensure reliable performance around preventive and chronic care outcome measures for all accountable populations and programs. This involves collaborating closely with key physician leaders, primary and specialty providers, and operational leadership to prioritize efforts, implement new initiatives and communicate updates and changes relevant to the quality program. Incumbent develops strong relationships with stakeholders including health plans. Incumbent works with analytic partners to track and trend performance and create feedback mechanisms to physicians and operational team.
Working in a dyad relationship with the Director, Quality and Performance Improvement, and the Director, Risk Management, the incumbent oversees the Voice of the Customer program, providing clinical input to patient complaints and grievances, analyzing trends, and working with operational teams to streamline service recovery and enhance the patient experience. Incumbent facilitates processes to support provider teams and represent patients when managing difficult interactions. Provides support to the Quality team in efforts to promote a Culture of Safety, including promoting incident reporting, transparent communication and a no-blame approach to errors. Works closely with the Chief Medical Officer on processes related to Credentialing and Peer Review. Uses data to understand problems and to identify tactics for improvement.
MD or DO required with completion of residency and board-eligibility in a medical specialty (board certification preferred).
Current valid license to practice medicine in the State of California required.
Board certification or board eligibility in one of the ABMS specialties required.
5 years minimum of progressive and successful physician leadership required; ten (10) years of prior work experience in a health care setting highly desired.
2 or more years’ experience in appeals and grievances review, case review, and/or quality improvement activities in a managed care setting, or equivalent, is preferred.
2 or more years HMO/Managed Care experience is preferred.
2 or or more years experience in NCQA/HEDIS, Medicare Star Ratings, Quality Improvement required.
Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.